Is the Nursing Licensure Exam effective?

[Double-Helix]

I'm posting this here, rather than the NCLEX board because I wanted the opinion of seasoned nurses, and the NCLEX board is primarily visited by students.

Spend a day on the NCLEX board and you'll see numerous threads that contain the phrasing, "I just took the NCLEX and I KNOW I failed!" or "It was so hard there is no way I passed!" or "I got the good pop-up but there is no way that I passed!"

It's gotten me thinking recently. The NCLEX gives you the opportunity to pass in 75 questions (only 60 of which count). It's a huge difference from the two day, multiple hours per day testing that many of you went through to get your license.

What often concerns me is that graduates can leave the NCLEX feeling sure that they failed, thinking that the test was super hard, and there is no way they could have passed. But, they did. Is this right? Should nursing licensure be summed up in 60 questions? If a student passes the NCLEX, but feels their performance was terrible, is that a red flag?

What's your opinion of the nursing licensure exam, and what changes should be made to the system?

[dudette10, MSN, RN]

Yuzzmatuzz, thanks for your post explaining CAT-based exams. Whether you found it ridiculously easy or ridiculously hard, it's important to keep in mind that everyone who passes gets about 50% of the answers wrong.

ETA: I personally found it ridiculously difficult. There were meds I had never even heard of, and I didn't think that was possible or realistic considering that my pharm class covered every drug class in our textbook. Nope, the names of the meds didn't even tickle the furthest reaches of my memory.

[subee, MSN, CRNA]

I don't have the opportunity to work with any new grads. But the NCLEX was obviously much too easy in my day (the 80's) because I have to work with some people who actually make be cringe because they are so intelletually "unsophisticated".

I wish they'd make it harder.

[tothepointeLVN, LVN]

Yuzzmatuzz, thanks for your post explaining CAT-based exams. Whether you found it ridiculously easy or ridiculously hard, it's important to keep in mind that everyone who passes gets about 50% of the answers wrong.

Actually not true. It is possible to answer every question correct but the computer can't shut down until the minimum # of questions has been reached. So someone who has it shuts off at the minimum has answered AT LEAST 50% correct ( though I've heard the actual figure as being 67% as the passing standard from someone who writes questions for the NCLEX) but theres a good chance they have answered far more than 50% in order for the the computer to not have any doubt as to their passing standard

When it shuts off at the minimum and you fail that mean the computer realized there wasn't enough questions left for you to be able to answer enough questions at the minimum competency level to pass.

The NCLEX is about assessing safety more than anything else. It wants to know are you minimally competent to be an entry level nurse.

[stablesystole]

Those that pass with 75 questions get the hardest of the hard questions, it's not a "potluck". Imagine a lateral line, the pass line. Imagine everyone starting out at the passing line at question #1. If you get it correct you move farther above the line and the next question is harder, and so on for every correct question. If you get the question wrong, you drop below the pass line and get an easy "killer"question; a question that doesn't matter in real nursing because your not proving your knowledgeable to answer questions that matter . The HURST review lady said that if you think you failed and it felt like the hardest test ever, you probably passed because you were in the really hard passing questions.I passed the NCLEX with 75 questions and it took me an hour and a half. I walked out worried that I didn't pass because I didn't think it was as hard as people were making it out to be. I did pass though. I also graduated with honors and raised my GPA in nursing school while most dropped. It's a test filled with anxiety...That aside, the NCLEX does not determine a "good" nurse, it is mearly a test of the MINIMUM competency required to be a nurse...it's the people that fail several times before passing tha worry me...

(sorry for any typos, I am on my phone)

I think this is generally true. Passing (or failing) at 75 questions means that your answer trend is so far past the curve that the test has no doubts left about what your scoring level is.

I walked out at 75 confident that I'd passed, but that was only because I went in knowing some details about the structure and level of questions that occupy the passing level. Holy multiple-multiples batman, I thought half of the test was select all that apply questions about setting priorities in patient loads.

[TopazLover, BSN, RN]

aky, did you take your boards in that big convention center in phoenix with me? i had just moved there from a new england state (what was i thinking?) and they told me to bring a sweater and i thought they were out of their minds, it was a hunnert and ten or more outdoors.

i brought the sweater the second day. and i was working evenings months later when i got my results.

actually i took them in nyc. i thought they were crazy to tell us to bring a sweater but i did follow directions well back then. of course i was hauling a sweater all around the big apple in between tests.

i was the evening nurse for 60 psych patients as a new grad. first time i saw medication side effect of high fever. first time i had to deal with post lobotomy pts. you could get lost in all the delusional systems intertwined in those pts. one of our most paranoid tried to buy a gun through the mail. (you could back then). i have often wondered if we would have survived if the head nurse did not open his mail and deny his right to privacy.